Medic Podiatry and Wound Care

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO2884 Issued in FL

Legal business name

MEDIC PODIATRY AND WOUND CARE

Practice address

3191 Harbor Blvd
Unit D
Port Charlotte, FL 33952-6755

Phone

(941) 613-1919

Fax

(941) 613-4077

NPI assigned

Jan 18, 2008

Last updated

May 2, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael R Metyk, DPM

Title

Podiatrist/Owner

Phone

(941) 613-1919

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MICHAEL R METYK DPM Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1093991101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191 HARBOR BLVD",
            "address_2": "UNIT D",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526755",
            "telephone_number": "941-613-1919",
            "fax_number": "941-613-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 HARBOR BLVD",
            "address_2": "UNIT D",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526755",
            "telephone_number": "941-613-1919",
            "fax_number": "941-613-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIC PODIATRY AND WOUND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "METYK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PODIATRIST/OWNER",
        "authorized_official_telephone_number": "941-613-1919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480031773",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICHAEL R METYK DPM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Podiatrist in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.